NPI age
17 years
Enumerated 2008-06-25
Across 5448 active family medicine providers in Georgia.
9 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (CA) | A139064 | STATE MEDICAL LICENSE |
Part of a multi-provider practice. 1593 other active providers share this practice address in NPPES.
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